Families' Additional Questions About Post-Op Recovery

The first 7 days following cleft lip surgery are the most critical period both for the baby's recovery and for the family's management of the process. When wound care, feeding routine, and follow-up appointments are properly planned during this time, recovery progresses quite smoothly in most babies.

What does the first 24–48 hours after surgery look like?

Noticeable swelling and mild bruising around the mouth in the first few hours after the baby comes out of surgery is entirely normal. These findings are part of the tissues' natural response to surgical intervention; they typically peak on the second or third day and then gradually subside. Parents knowing about this appearance in advance largely prevents unnecessary panic.

During the first 24 hours, the baby is usually kept under observation in the ward or intensive care unit. Pain management is provided with analgesics determined by the physician; excessive crying can both stress the wound and increase swelling. For this reason, calming environments, soft music, or a pacifier (used carefully while arm restraints are in place) can help soothe the baby. Elbow restraints that prevent the arms from bending stop the baby from touching the wound with their hands; wearing these devices typically continues for several weeks from discharge in most cases.

When does discharge usually take place?

In cases without complications, discharge typically occurs the day after surgery or on the second day. However, every baby's situation is different; your team will assess the timing of discharge. Upon transition home, the family must have discharge instructions, emergency contact numbers, and information about the first follow-up appointment.

How should wound care be performed?

The sutures used in cleft lip surgery are mostly self-dissolving and do not need to be removed separately. However, the suture area requires daily and regular cleaning. Unless recommended by the physician, commercial antiseptic solutions should be avoided; gentle cleaning with sterile saline solution or a wet cotton-tipped swab is sufficient in most cases.

After cleaning, applying a thin layer of the antibiotic ointment prescribed by the physician both keeps the area moist and minimizes crust formation. When crust formation is not prevented, the risk of scarring may increase relatively; therefore, regular use of the ointment is important. If the baby's saliva or food residue comes into contact with the wound area during the day, gently cleaning the area and reapplying the ointment is appropriate.

When should sun protection begin?

To prevent scar tissue from darkening, direct sun exposure of the wound area should be avoided. If the baby is outdoors, a hat and shade are sufficient; applying sunscreen directly to a freshly closed wound is not recommended without physician approval. Asking about this at a follow-up visit will ensure you receive clear guidance.

How are feeding and oral hygiene maintained?

Post-operative feeding is the area families find most challenging. To prevent the nipple or breast from pressing on the lip wound, special post-operative bottles or soft-tipped feeding tools can be used. The feeding method approved by your physician will be demonstrated to you at discharge; it is natural for the baby to go through a slow adaptation period during the first few feeds.

Cleaning the inside of the mouth and the area around the lips after each feeding prevents food residue from accumulating at the suture site. A soft gauze pad moistened with sterile saline solution can be used for this cleaning; firm pressure must absolutely be avoided. Some babies may feed less or keep feeds short during the first few days; it is important to share this with your physician, as adequate nutrition directly affects both overall recovery and wound healing.

Can breast milk be given?

Breast milk is preferred when possible due to its immunological value. If direct breastfeeding is not possible, expressing milk and delivering it with an appropriate feeding tool is a viable option in most cases. Evaluating this matter together with your surgeon and pediatrician will help you determine the most appropriate approach for your baby.

When and how should follow-up appointments be scheduled?

The first follow-up appointment is generally scheduled 5–7 days after discharge. At this visit, the surgeon evaluates wound healing, checks the condition of the sutures if necessary, and decides whether to continue the ointment. Photographing and monitoring the wound area before the appointment can contribute to the surgeon's assessment.

If you notice any of the following during the first week, it is recommended that you call your clinic without waiting for the appointment: significant redness or discharge at the suture site, the baby's temperature exceeding 38°C, complete refusal to feed, or the impression that the sutures have separated. These findings do not always indicate a serious problem; however, early evaluation in most cases either relieves unnecessary concern or accelerates the necessary intervention.

If you would like general information about cleft lip and palate, you can refer to our article where we address the topic in detail. If you are curious about how this condition develops and the big picture of the treatment process, you can benefit from our article explaining the causes and treatment of cleft lip and palate. What families need to do during the pre-operative preparation period is also covered comprehensively in a separate article.

You can make an appointment to receive general information about lip and palate clefts or to consult with Prof. Dr. Mithat Akan. For additional questions that come to mind during the post-operative process, you can also refer to our dedicated question-and-answer article.